Abstract
Renal and vascular damage, including blood pressure elevation, is often involved in complications of diabetic pregnancy. Therefore, sensitive methods for measuring elevatedurinary protein excretion, especially of albumin (so-calledmicroalbuminuria) [1–3], might be useful in early prediction of complications in diabetic as well as nondiabetic pregnancy. This is the case in nonpregnant diabetics [3–9], in whom microalbuminuria is a sensitive marker of generalizedsubclinical vascular disturbance and damage [6] and in whom it predicts overt nephropathy [3–6] as well as proliferative retinopathy [7]. In a normal pregnancy, increases in UAER are either absent or very limited [10–12]. However, certain low-molecular weight plasma protiens may increase in excretion rate [13]. There are certainly increases in albumin uria when preeclampsia is present [14,23]. This chapter deals with the pattern of urinary albumin excretion rate in diabetic pregnancy as studied with a sensitive radioimmunoassay for albumin using 24-h urine samples. Patients with overt nephropathy are discussed in Chapter 42.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Mogensen CE. Microalbuminuria as a predictor of clinical diabetic nephropathy. Kidney Int 1987; 31: 673–689.
Viberti GC, Mackintosh D, Bilous RW, Pickup JC, Keen H. Proteinuria in diabetes mellitus: role of spontaneous and experimental variation of glycaemia. Kidney Int 1982; 21: 714–720.
Mogensen CE, Christensen CK. Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med 1984; 311: 89–93.
Viberti GC, Hill RD, Jarrett RJ, Argyropoulos A, Mahmud U, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet 1982; i: 1430–1432.
Parving H-H, Oxenbøll B, Svendsen PAa, Christiansen JS, Andersen AR. Early detection of patients at risk of developing diabetic nephropathy: a longitudinal study of urinary albumin excretion. Acta Endocrinol (Copenh) 1982; 100: 550–555.
Mathiesen ER, Oxenbøll B, Johansen K, Svendsen PAa, Deckert T. Incipient nephropathy in type 1 (insulin-dependent) diabetes. Diabetologia 1984; 26: 406–410.
Vigstrup J, Mogensen CE. Proliferative diabetic retinopathy: at risk patients identified by early detection of microalbuminuria. Acta Ophthalmol 1985; 63: 530–534.
Feldt-Rasmussen B. Increased transcapillary escape rate of albumin in type 1 (insulin-dependent) diabetic patients with microalbuminuria. Diabetologia 1986; 29: 282–286.
Feldt-Rasmussen B, Mathiesen E, Deckert T. Effect of two years of strict metabolic control on the progression of incipient nephropathy in insulin-dependent diabetes. Lancet 1986; ii: 1300–1304.
Mogensen CE, Klebe JG. »Microalbuminuria and diabetic pregnancy.« In The Kidney and Hypertension in Diabetes Mellitus. Mogensen CE, ed. Boston, Dordrecht, London: Kluwer Academic Publishers, 1994; pp 381–388.
Mogensen CE, Hansen KW, Klebe J, Christensen CK, Schmitz A, Mau Pedersen M, Pedersen EB, Jespersen B, Petersen RS, Christiansen JS, Schmitz O, Damgaard EM, Frøland A. »Microalbuminuria: Studies in diabetes, essential hypertension, and renal diseases as compared with the background population.« In Advances in Nephrology. Grünfeld JP, ed. Chicago: Mosby Year Book, 1991; 20: 191-228.
Misiani R, Marchesi D, Tiraboschi G, Gualandris L, Pagni R, Goglio A, Amuso G, Muratore D, bertuletti P, Massazza M. Urinary albumin excretion in normal pregnancy and pregnancy-induced hypertension. Nephron 1991; 59: 416–422.
Bernard A, Thielemans N, Lauwerys R, van Lierde M. Selective increase in the urinary excretion of protein 1 (Clara cell protein) and other low molecular weight proteins during normal pregnancy. Scand J Clin Lab Invest 1992; 52: 871–878.
Brown MA, Wang M-X, Buddie ML, Carlton MA, Cario GM, Zammit VC, Whitworth JA. Albumin excretory rate in normal and hypertensive pregnancy. Clin Sci 1994; 86: 251–255.
Miles DW, Mogensen CE, Gundersen HJG. Radioimmunoassay for urinary albumin using a single antibody. Scand J Clin Lab Invest 1970; 26: 5–11.
Mogensen CE. »Microalbuminuria and kidney function in diabetes: Notes on methods, interpretation and classification.« In Methods in Diabetes Research, volume II: Clinical Methods. Clarke WL, Larner J, Pohl SL, eds. New York, Chichester, Brisbane, Toronto, Singapore: John Wiley & Sons, 1986; pp 611–631.
Mogensen CE, Chachati A, Christensen CK, Close CF, Deckert T, Hommel E, Kastrup J, Lefebvre P, Mathiesen ER, Feldt-Rasmussen B, Schmitz A, Viberti GC. Microalbuminuria: an early marker of renal involvement in diabetes. Uremia Invest 1985–86; 9: 85–95.
Biesenbach G, Zazgornik J, Stöger H, Grafinger P, Hubmann R, Kaiser W, Janko O, Study U. Abnormal increases in urinary albumin excretion during pregnancy in IDDM women with preexisting microalbuminuria. Diabetologia 1994; 37: 905–910.
Biesenbach G, Zazgornik J. Incidence of transient nephrotic syndrome during pregnancy in diabetic women with and without pre-existing microalbuminuria. BMJ 1989; 299: 366–367.
McCance DR, Traub AI, Harley JMG, Hadden DR, Kennedy L. Urinary albumin excretion in diabetic pregnancy. Diabetologia 1989; 32: 236–239.
Pedersen EB, Rasmussen AB, Johannesen P, Lauritsen JG, Kristensen S, Mogensen CE, Sølling K, Wohlert M. Urinary excretion of albumin, beta-2-microglobulin and light chains in preeclampsia, essential hypertension in pregnancy and normotensive pregnant and non-pregnant control subjects. Scand J Clin Lab Invest 1982; 41: 777–784.
Lopez-Espinoza I, Dhar H, Humphreys S, Redman CWG. Urinary albumin excretion in pregnancy. Br J Obstet Gynaecol 1986; 93: 176–181.
Irgens-Møller L, Hemmingsen L, Holm J. Diagnostic value of microalbuminuria in preeclampsia. Clin Chim Acta 1986; 157: 295–298.
Freinkel N, Dooley SL, Metzger BE. Care of the pregnant woman with insulin-dependent diabetes mellitus. N Engl J Med 1985; 131: 96–101.
Pedersen J. The Pregnant Diabetic and Her Newborn, 2nd ed. Copenhagen: Munksgaard, 1977.
Redman DWG. The definition of pre-eclampsia. Scand J Clin Lab Invest 1984; 44: Suppl. 169: 7–14.
Gregorini G, Perico N, Remuzzi G. »2. Pathogenesis of preeclampsia«. In The Kidney in Pregnancy. Andreucci VE, ed. Boston: Martinus Nijhoff, 1986; pp 13–33.
Mogensen CE, Poulsen PL, Heinsvig EM. »Abnormal albuminuria in the monitoring of early renal changes in diabetes.« In Concepts for the Ideal Diabetes Clinic. Diabetes Forum Series, Volume 4. Mogensen CE, Standi E, eds. Berlin, New York: Walter de Gruyter, 1993; pp 289–313.
Klebe JG, Mogensen CE, Christensen T. »Nephropathy in Pregnancy.« In Carbohydrate Metabolism in Pregnancy and the Newborn IV. Sutherland HW, Stowers JM, Pearson DWM, eds. London, Berlin, Heidelberg, New York, Paris, Tokyo: Springer Verlag, 1989; pp 173–187.
Lauszus FF, Klebe JG, Rasmussen OW, Klebe TM, Dørup J, Christensen T. Renal growth during pregnancy in insulin-dependent diabetic women. Acta Diabetol 1995; 32: 225–229.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1996 Springer Science+Business Media New York
About this chapter
Cite this chapter
Mogensen, C.E., Klebe, J.G. (1996). Microalbuminuria and Diabetic Pregnancy. In: Mogensen, C.E. (eds) The Kidney and Hypertension in Diabetes Mellitus. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6749-0_41
Download citation
DOI: https://doi.org/10.1007/978-1-4757-6749-0_41
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-6751-3
Online ISBN: 978-1-4757-6749-0
eBook Packages: Springer Book Archive